Prevent Unfair Claims Acts and Low Settlement
Valuation for Personal Injury
The guidelines for processing private health insurance and Medicare claims
differ drastically from personal injury and auto accident claims. In fact, the
data required is so different that you need two different electronic health
records.
Attorney Aaron DeShaw:
"Only a minority of lawyers and doctors have a clue what's going on.
We are excited to partner with the EMR Company listed on this site to empower
those who practice in personal injury to collect maximum reimbursement because
your documentation will now meet the auto insurance company's Colossus
expectations.
Zeusclaim goes beyond the demand of medical-legal professional responsibility
and accountability, it is also about FREEDOM from the suppression of insurance
adjuster and IME disputes, denials and omissions of claim factors and unfair,
unrealistic, low settlement values assigned to injured parties by the insurance
companies.
Court cases and Regulatory fines into the millions have revealed the insurance
companies use Unfair Claims Practices and software Tuning Bias to 'de-value'
and cut claim settlement valuation.
The insurance companies' software determines settlement values based on an
Artificial Intelligence system whereby CODES, referred to as insurer "DECISION
POINTS" represent a dollar amount.
If the attorney or physician do not incorporate these DECISION POINTS in their
respective documentation S.O.A.P. notes and demand letter, in the correct
terminology, format and sequence, the windows of the insurer's personal injury
software do not open and compensation for these decision points associated with
the injuries and point factors is lost.
This process is so detailed & complex that the public must rely upon those
doctors and attorneys that are educated in this PI environment. To do otherwise
would give back large portions of the settlement to the insurance industry &
leave large amounts of dollars that were already determined to be paid in the
settlement.
Zeusclaim is the software equalizer to mitigate the insurance company's software
as Colossus by prompting both the doctor and the attorney to include all
applicable Decision Points in the medical documentation and demand letter to
offset unfair, low valuation.